Nicole M Koperda, NCSP, MA/CAGS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

1082284 Issued in NY

Practice address

378 Charles Ave
Massapequa Park, NY 11762-1601

Phone

(516) 274-2076

NPI assigned

Jun 15, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• None None None Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1437727591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 CHARLES AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621601",
            "telephone_number": "516-274-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 CHARLES AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621601",
            "telephone_number": "516-274-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPERDA",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NCSP, MA/CAGS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "1082284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "NONE",
            "middle_name": "NONE",
            "credential": "SINGLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas Kelly, PHYSICAL THERAPY
• Donna B. Kimick, IBCLC, RLC
• Charles H King, PH.D.
• Larry Kirschner, RN
• David Kommor, D.C.
• Sandra Kopman, LCSW
• Jacqueline Kopp-Accurso, LMT
• Donna Marie Kowalczyk-Falcone, PT
• Karen Ann Kramer-Klein, MACCCSLP
• Catharine Kremm

• School Psychologist in Massapequa Park, NY
• Providers in Massapequa Park, NY by specialty
• School Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.